Background: Chronic and persistent alcohol use is known to induce sexual dysfunction, which leads to marked distress and interpersonal difficulty.
Aim: We attempted to assess the prevalence of sexual dysfunction in a clinical sample of subjects with alcohol dependence.
Materials and Methods: One hundred male subjects admitted to a deaddiction centre with a diagnosis of alcohol dependence syndrome with simple withdrawal symptoms (F10.30, ICD-10 criteria) were assessed for sexual dysfunction using a sexual dysfunction checklist, constructed using items from the Diagnostic Criteria for Research [ICD-10] for sexual dysfunction.
Results: Seventy-two per cent had one or more sexual dysfunction, the most common being premature ejaculation, low sexual desire and erectile dysfunction. The amount of alcohol consumed appeared to be the most significant predictor of developing sexual dysfunction.
Conclusion: Sexual dysfunction is common in patients with alcohol dependence. Heavy drinking proportionately increases the risk. Clinicians need to routinely assess sexual functioning in alcoholic patients so that other factors contributing to sexual dysfunction can be ruled out.

Background: Nonfatal, deliberate self-harm (DSH), particularly with pesticides, is a major public health problem in many developing countries of the world. Agriculture is the primary occupation of most people living in the Sundarban region in West Bengal, India. Pesticides are extensively used in agriculture and these agents are most frequently used in DSH.
Aim: This study sought to identify the nature of methods and agents used in nonfatal DSH attempts in the Sundarban area under South 24 Parganas district of West Bengal.
Materials and Methods: Detailed demographic and clinical data on DSH cases of 13 Block Primary Health Centres (BPHCs') admission registers were analysed. Focus Group Discussions (FGDs) were conducted with the Panchayat Samithy of each block to elicit their perception about the problem of pesticide-related DSH or suicide in the region.
Results: Five thousand, one hundred and seventy-eight (1,887 male and 3,291 female) subjects were admitted in the BPHCs during the study period from 1999 to 2001. Organophosphorous pesticide poisoning was found to be the most common method (85.1%) in DSH. This emphasizes the importance of developing an urgent poisoning prevention program with a special focus on improving clinical services as well as initiating farmers' education programs focusing on safe pesticide practices at the primary care level.

The trail making test (TMT) is a short and convenient estimate of cognitive functions, principally attention and working memory. Like most neuropsychological tests, it is derived from and primarily applicable to English-speaking individuals. Norms for other ethnic minorities may differ significantly. The application of majority or mixed norms to specific ethnic subcultures may introduce systematic bias. To examine the impact of an English test on primarily nonEnglish-speaking individuals, outpatients attending the dermatology department of a large Indian hospital ( n = 120) were asked to complete the English version of the TMT. The time taken to complete the TRAILS was unexpectedly long, although all the subjects scored within normal limits on the modified mini mental status examination and a test for general knowledge. Possible reasons for the delayed completion times are discussed below.

Stressful life events among adolescents: The development of a new measureShilpa Aggarwal, H.R.A Prabhu, Aalok Anand, Atul KotwalApril-June 2007, 49(2):96-102DOI:10.4103/0019-5545.33255 PMID:20711390

Background: Adolescence can be a stressful time for children, parents and adults who work with teens. We believe that a scale measuring the events perceived as stressful by an average Indian adolescent is necessary due to the presence of irrelevant items and absence of items related to our culture on foreign scales.
Aim: This study was done to adapt and test the validity of a scale measuring stress caused due to life events in an Indian adolescent; to assess clinical value of the instrument in exploring causal relationships between stressful events and behavioral problems; and to compare the degree of overlap in stress-causing events between adolescents and their parents during the same timeframe.
Materials and Methods: An adolescent life event stress scale (ALESS) containing 41 items was administered to 156 adolescents for formulation and 102 adolescents for validation. A third set of 112 adolescents was used to compare ALESS scores with child behavior checklist (CBCL) scores and parental stress scores due to life events.
Results: The comparison showed a strong positive correlation with CBCL scores with a model fit (r 2 = 0.32) and a weak positive correlation with parental stress (Pearson's coefficient = 0.011) due to life events.
Conclusion: Thus, a life event scale for adolescents was especially adapted to the Indian conditions.

Background: Seasonal and monthly variations in utilization of psychiatric services have been inadequately studied in India.
Aims: This study sought to determine the pattern of psychiatric services utilization by patients with four broad categories of diagnosis (mood disorders (F30-39): neurotic stress-related and somatoform disorders (F40-48), schizophrenia, schizotypal and delusional disorders (F20-29) and mental and behavioral disorders due to psychoactive substance use (F10-19) in different seasons and months of the last six years.
Materials and Methods: We conducted a teaching hospital data-based study of new patients diagnosed with psychiatric illness in the department of psychiatry, Government Medical College and Hospital, Chandigarh. Four diagnostic groups consisting of 12058 psychiatric patients who had been diagnosed and treated in the department of psychiatry of this institute from 1999-2004 were included in this evaluation. Bed occupancy rate (BOR), average length of stay (ALOS) of inpatients and seasonal index were determined. Information about weather variables (mean daily temperature, mean rainfall) was collected from the meterological department of Chandigarh.
Results: Psychiatric services were utilized by 31.1% of patients with mood disorders in the summer and by 34.23% of patients with neurotic, stress-related and somatoform disorders in the autumn. Statistical analysis revealed significant difference in new cases of these two groups of disorders in different seasons.
Conclusion: Our study showed a significant relationship between utilization of psychiatric patients especially with mood disorders and neurotic, stress related and somatoform disorders with season (summer and autumn respectively).

Background: Recent information on psychiatric morbidity in industrial employees is not available in India. Such information may help in building mental health care for this population.
Aim: The aim was to study the prevalence of psychiatric morbidity and the risk factors associated with it in an industrial population.
Materials and Methods: Two hundred thirty-eight individuals were selected by a stratified randomisation technique and screened using the General Health Questionnaire-12 (GHQ-12), Johns Hopkins University Hospital Test for alcoholism and a semistructured questionnaire for other substance use, sleep problems and past psychiatric history. Following a detailed clinical interview, diagnoses were based on International Classification of Diseases (ICD)-10, Classification of Mental and Behavioural Disorders: Diagnostic Criteria for Research (DCR).
Results: The prevalence rate for psychiatric disorder of one month's duration in the study population was 51.7%. Substance use, depression, anxiety and sleep disorders were common. Comorbidities were found in 65% of the subjects. Both univariate analysis and stepwise multiple regression revealed that educational level, perceived stress, job satisfaction and stressful life events were the independent determinants of psychiatric morbidity.
Conclusion: A significant proportion of industrial employees had psychiatric morbidity and many psychosocial factors were associated with caseness.

Drug dependence is a major cause of morbidity and loss of productivity. Various theories ranging from economic to psychological have been invoked in an attempt to explain this condition. With the advent of research at the cellular and subcellular levels, perspectives on the etiology of drug dependence have also changed. Perhaps the greatest advance has been in the identification of specific receptors for each of the drugs, their target neurotransmitter systems and the intracellular changes produced by them. These receptors also provide potential targets for treatment strategies of drug dependence. This overview attempts to present the mechanisms in the development of dependence and the newer treatment strategies for the major drugs of abuse like alcohol, opioids, cannabis, nicotine and cocaine.

This is a report of a case of recurrent depression with hypertension, ischemic heart disease and diabetes mellitus which switched to mania while on escitalopram. Escitalopram, one of the newer selective serotonin reuptake inhibitors (SSRIs), is considered to have fewer adverse effects and a lower propensity for drug interactions. However, escitalopram may induce mania at a maximum dose of 20 mg especially when given with Alprazolam which is known to boost efficacy of SSRIs.

Somnambulism is an arousal disorder that is usually benign, self-limited and only infrequently requires treatment. Chronic sleepwalking in children has been shown to be associated with behavioral problems and poor emotional regulation. Most cases can be diagnosed with careful noting of case history and epilepsy is an important differential diagnosis. Management with pharmacological and behavioural measures is usually safe and effective. We present two cases of somnambulism that highlight the importance of the diagnosis and treatment of this condition.

Background : Confounding is a statistical concept that is important to all researchers.
Materials and Methods: The concept of confounding is explained with the help of an amusing but true example. Simple explanations about and examples of confounding are provided. Methods to deal with confounding are detailed and their applications and disadvantages are examined.
Conclusions : Attention to confounding is necessary at the time of study design as well as during the statistical analysis of data. The failure to identify and control for confounding can result in the faulty interpretation of study outcomes.